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As I described in my previous blog, Attachment Theory and Polyvagal Theory can be used to provide greater insight into understanding how to support the emotional well-being and mental health of children and young people (CYP) with severe and complex learning needs.

I wrote about how attachment relationships are important in a child’s development, giving an example of a typical experience for staff working within schools. The example showed how interactions of this nature can be used to establish a positive and trusting relationship between an adult and any child.

In the same situation with a child with severe and complex learning needs, where a child’s language and communication skills are likely to be severely limited, the positive attachment needs are still important. However, to achieve a positive outcome the adult will need to be aware of other influencing factors that will drive a child’s response both consciously and unconsciously.

Polyvagal Theory and Unconscious Drives

Polyvagal Theory describes how these types of interactions, both consciously and unconsciously, can regulate a child’s physiological states. The theory is named after the Vagus nerve which is a Greek word meaning ‘wanderer’. It is the longest single nerve from the brain connecting to all the major organs of the body.

The Vagus nerve passes information back and forth between the body and the brain, using this to monitor all the body’s systems and the levels of safety, risk or threat in any situation.

The more complex brain structures use this information to quickly and instantly trigger a physiological response based on how ‘safe’ a child feels. If they do not feel safe the response may be fight, flight or freeze. Whereas, if they do feel safe then there is more openness and warmer interactions.

Sense of Safety

Within Polyvagal Theory a ‘Sense of Safety’ is central to how we all respond to daily experience, how we build connections within our brain through our daily interactions as we grow. These connections can link different parts of the brain to build and reinforce our own internal world view.

Polyvagal Theory identifies the importance of our connections to others in creating our ‘Sense of Safety’ initially for survival, then through repeated experiences, it becomes part of how our physiological systems respond and is very dependent upon how we build relationships with others.

As in Attachment theory, there is a recognition that we are each born to connect with others in order to live, thrive and flourish within our own world.

Organising Processes within Polyvagal Theory

Polyvagal Theory describes how the human brain has developed over time, emphasising the importance of relationships and social interaction in maintaining a sense of safety. It has 3 organising processes that describe the responses and what is happening consciously and unconsciously in our brains.

  1. Neuroception

NEUROCEPTION means ‘detection without awareness’ which is our intuitive response. It is the level of agitation or arousal through which a child has learned whether a situation is safe or presents a danger to them.

A child’s perception of risk and the level of arousal can begin with a ‘sense of unease’, one that can be observed by those caring or supporting them. This will then link to feelings and memories which instantaneously create a response, most often without conscious awareness, using the previous and repeated ways they have responded.

Together NEUROCEPTION and the patterns of responding help a child to interpret the level of safety or danger based on their previous experience. The nature of an individual’s life experiences will have a tremendous influence on their ability to regulate themselves as they draw on the support they have received from carers and school staff. This support becomes increasingly more important for CYP with complex and profound needs.

  1. The Face-Heart System

The FACE-HEART SYSTEM or ‘social engagement system’ describes how the nerves of the head and face take information back and forth to the brain and links to the heart through the Vagus nerve. The nerves connect to the eyes, ears, face muscles and parts of the neck and the activity of these nerves can regulate the heart rate via the Vagus.

This can be seen in the way a child begins to interact with others. Their unconscious neuroception begins to react and assess the situation for signs of safety or danger. There is a vast range of information passing back and forth from a child and those around them.

Facial expressions…

send out signals to help interpret what is happening, both eye contact and eye shape, whether small moist eyes or wide dry eyes, will offer signals and impact on a child’s ‘sense of unease’. The muscles of the ear can alter the range of sounds a child will pay attention to as their ‘sense of unease’ changes.

If their ‘sense of unease’ increases this can prompt a change in the muscles of the neck and along with changes in the muscles of the face they can support any changes in the rate of breathing. If a child begins to feel more anxious, an increase in breathing rate can prepare a ‘flight, fight or freeze’ response.

All the while this information is moving instantaneously back and forth through a child’s nervous system relying heavily on previous feelings and memories in how to respond to keep safe.

They only do what they do by whatever means they know how’

The actions and reactions between the Face-Heart System and the neuroception of safety or threat form the SOCIAL ENGAGEMENT SYSTEM and are the starting point for connection and change for any child.

  1. Co-regulation

The third process is CO-REGULATION and in Polyvagal Theory is seen as necessary to maintain life. It is important because a child learns to self-regulate their own nervous system through consistent experiences with another co-regulating calming nervous system.

A child comes into the world with certain regulating systems to ensure survival through connection with others, e.g., making eye contact, a warm smile, etc. Interactions can then create experiences that will link with the reduction of stress or anxiety and offer an important sense of safety.

Little girl blends phonics sounds using the magnetic feature of the Clever Tiles.

Over time the information passed back and forth between the body and the brain, with the Vagus nerve playing an essential role, shapes and re-shapes how a child responds as their experience and knowledge of their world increases.

An infant’s knowledge of the world begins from birth and builds as the world is brought to them by carers. As an infant connects and interacts with carers, they rely upon their physiological responses to express their own emotions and behaviour, to reflect the level of stress and anxiety they feel and their need for help to regulate these feelings and return to a sense of safety.

The importance of interaction

There is no sense of the behaviour being ‘good’ or ‘bad’. It is simply the best that the child knows at this stage in their growth and development in order to respond to the risk and associated stress and anxiety as they try to maintain or return to a sense of safety.

No child can do this alone. They rely upon carers to respond positively and regulate the experience in ways that enable them to learn to regulate themselves. The offer of a successfully regulated interaction by a carer can have a physiologically calming effect that an infant can begin to ‘mirror’ over time.

As a child co-regulates with the carer, they learn to adapt their own physiological responses, consciously and unconsciously, and begin to successfully self-regulate.  How to achieve this as a child’s needs become more complex requires greater awareness and understanding on the part of the supporting adult.

Co-regulation is an essential foundation in both Attachment Theory and Polyvagal Theory to support children’s emotional well-being and mental health.

Awareness of how we self-regulate

The Social Engagement System can be seen in our own behaviour. We can observe it in our breathing and heart rate, how comfortably we look at someone’s face, how we make eye contact and our body posture, how we feel involved in what is happening in the moment and are able to reach out to others, how we are connected to the world and those we are currently sharing it with.

We experience this on a moment-by-moment basis and things can happen that can interrupt this or upset us. This change requires a response from us that assesses the risk associated with it. The response begins physiologically at an unconscious level – neuroception. This may result in increased heart rate and breathing, looking around to assess the situation and increased physical response to protect yourself or take you out of that situation – is fight, flight or freeze needed?

In addition, there is a cognitive response that involves memories and previous experience of dealing with similar levels of arousal from the co-regulation we have experienced in our attachment relationships. From the activity across different areas of the brain we go on to make decisions about what to do very quickly and these decisions will begin to influence our physiological response and self-regulation.

An Example: An incident at a party

You are at a party. You are relaxed and comfortable talking to people you know. You’re enjoying the conversation and suddenly a tray crashes to the floor behind you.

You immediately startle, your heart rate increases, your breathing changes. It may begin with a sharp intake of breath. You become more aware of your surroundings as you look around to see what has happened.

You then see that someone has dropped a tray and experience tells you there is nothing to worry about. Your heart rate and breathing begin to slow. You may even laugh a little to release any tension as your feelings of calm and enjoyment return and you go back to your conversation.

However, would your response be the same if the tray was full of glasses of red wine and some of it ended up over you and your favourite clothes? How easy would it be for you to return to your previous feelings of calm and enjoyment?

Your response will go beyond the immediate startled sense of danger and risk and bring in wider feelings, emotions and memories. How you respond will rely a great deal upon how you manage your emotions, all of which you have learned through previous experience (memories) and the support of those around you (co-regulation).

How would you respond?

  • Would you be stunned and shocked, unable to know what to do next, in a state of shutdown or freeze?
  • Would you explode with anger or be so distressed and embarrassed that you must leave immediately? This would be a fight or flight response as you find it difficult to self-regulate or connect with others to manage the situation.
  • Or would you be able to remain connected within your social engagement system and be able to regulate yourself, using your connection to others when needed to move to a positive outcome and deal with what has happened?

Life experiences

Clearly our early life experiences have formed the links cognitively and neurologically that go on to shape our internal world view. The extent to which we have been successful in managing our perception of risk and regulating our emotions in situations, enables us to feel we can cope and are resilient. The extent to which CYP with complex needs are able to do this requires a great deal of reflection and understanding on the part of carers and school staff.

A Dynamic Process

Success in dealing with situations needs input from more complex areas of the brain. When a CYP with complex needs perceives risk as high they are likely to have fewer resources to manage the increasing arousal levels and the likelihood of maintaining a sense of safety becomes harder.

It is through their physiological responses as a result of neuroception and the activity of the face-heart system, the social engagement system, that they can assess how much risk they see in what is happening in the moment. They need to be able to use the complex areas of the brain to decide how this compares to what they have experienced in the past. To do this will require attuned and empathetic support from a calm and self-regulating adult.

A dynamic process

If we see this as a dynamic process, one that can be repeated time and time again we can begin to see how our actions can reinforce positive and enriching outcomes. They can be an opportunity to offer a different outcome to a child whose instinctive internal world view may be that:

Any time my heart rate and breathing increases there is a significant risk, danger or threat to me and one that will likely have a negative outcome or overwhelm me.

How well a CYP with complex needs manages to cope and regulate themselves for potentially different outcomes in the future will rely a great deal on knowing how they cope at present and how they can be supported to build resilience and learn to manage their own feelings and emotions.


In my next blog I will offer a case study worked example that brings together Attachment Theory and Polyvagal Theory in the school and classroom.

With thanks to Tom Laverty for this series of blogs.

Tom started work as a residential social worker in a respite centre for children with complex learning needs and their families. He then worked as a teacher for 27 years in a school for children with severe learning difficulties, Profound and Multiple Learning Difficulties and autistic spectrum disorders.

Tom is now a member of the Emotionally Able team supporting and training practitioners within specialist settings across London and nationally.


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